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Does a social model of hospice day care affect advanced cancer patients’ use of other health and social services? A prospective quasi-experimental trial

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Abstract

Background

Hospice day care (HDC) services have developed but no trials evaluate their impact on the other health and social care services.

Purpose

The purpose of this study was to evaluate the effect of HDC on the use of health and social services in a prospective quasi-experimental study.

Methods

The trial compared consecutive patients receiving HDC, with two control groups: a ‘before’ group and a ‘standard care’ group. All data was collected in face to face interviews at baseline and then at 6–8 weeks and 12–15 weeks. The health and social service use at baseline and follow-up interviews were examined by five categories (community, hospice, social care support, hospital, and therapist). The multivariate analysis of covariance (MANCOVA) was used to test service use differences between groups, adjusting for potential confounders.

Results

In total, 37, 50, and 76 patients were recruited to the day care, standard care and before groups. Patients in the HDC group used significantly more social care support (11.5 ± 18.9 versus 3.2 ± 10.0, P = 0.015) and therapists (0.9 ± 1.7 versus 0.2 ± 0.4, P = 0.009) than the standard care at the baseline. The therapist service use from the baseline to the first follow-up reduced (mean change ± SD, −0.3 ± 0.6; 95%CI, −0.7 to 0.0) in the HDC group and increased in the standard care group (mean change ± SD, 0.1 ± 0.5; 95%CI, −0.1 to 0.3), the difference was significant (P = 0.003). No other changes in service use were significant in other study periods.

Conclusions

HDC appears to supplement existing services with little effect on the other community and hospital services.

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Acknowledgments

We thank the staff, patients, and families at St Wilfrid’s Hospice, Chichester for their participation in the study, members of the Project Advisory Group for their participation in the study design and data collection, and in particular, Hannah-Rose Douglas and Danielle Goodwin for their contribution to data collection and study organization. We thank the NHS Executive, South East, for funding this project. The funding body has no role in the study design, collection, analysis, and interpretation of the data, the report, nor in the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. School of Medicine at Guy’s, King’s College and St Thomas’ Hospitals, Department of Palliative Care, Policy and Rehabilitation, King’s College London, Weston Education Centre, 3rd Floor, Cutcombe Road, Denmark Hill, London, SE5 9RJ, UK

    Irene J. Higginson & Wei Gao

  2. St Wilfrid’s Hospice Chichester, Chichester, UK

    Brendan Amesbury

  3. Trinity College, Health Policy & Management, University of Dublin, Dublin, Ireland

    Charles Normand

Authors
  1. Irene J. Higginson
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  2. Wei Gao
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  3. Brendan Amesbury
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  4. Charles Normand
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Corresponding author

Correspondence to Irene J. Higginson.

Appendix

Appendix

Table 4 Mean frequency and mean frequency change of service use at baseline, first and second follow-up interview by hospice day care (D), standard palliative care (S) and before group (B) with multiple imputed data
Full size table
Table 5 Mean frequency and mean frequency change of service use at baseline, first and second follow-up interview by hospice day care (D), standard palliative care (S) and before group (B) with non-imputed data
Full size table

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Higginson, I.J., Gao, W., Amesbury, B. et al. Does a social model of hospice day care affect advanced cancer patients’ use of other health and social services? A prospective quasi-experimental trial. Support Care Cancer 18, 627–637 (2010). https://doi.org/10.1007/s00520-009-0706-3

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  • DOI: https://doi.org/10.1007/s00520-009-0706-3

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